Discounts

by  Wyn Staheli, Director of Research
December 7th, 2016

All healthcare providers need to be aware that there are both appropriate and inappropriate ways to discount your fees. Both state and federal laws can impact your practice financial policy regarding fee discounts. Additionally, we recommend carefully reviewing Chapter 1.5 - Establishing Fees of a specialty specific Reimbursement Guide book for important information on fee schedules and discounts.

Different types of healthcare discount programs are available in the market today and providers need to understand that discount programs are NOT health insurance. Not all discount programs are created equal. Some are not entirely legitimate.

Before signing up; carefully evaluate any healthcare discount program by asking the following questions:

  1. Are they properly registered, approved or licensed if required in your state and do they meet all state regulations?
  2. What are the enrollment costs/fees? The costs for either the provider and/or the patient might not balance out any benefits.
  3. What are the provider's renewal and cancellation fees? Do you have the ability to opt-out at any time?
  4. Do they offer refunds as required by state regulations? If so, what are those refund policies for both the patient and the provider?
  5. What does the BBB say about them? Not every business has a BBB rating, but if they have complaints, that could be a red flag.
  6. What about Medicare? If you see patient's over age 65, you need to be aware of all Medicare rules and regulations and how this plan affects your Medicare patients and your practice billing policies.
  7. Is the plan owned by an insurance carrier?
  8. Are the discounts set by the plan or do the providers have the options to choose the level of discounts and services that will be discounted?
  9. Does the plan have the ability to "sell or rent" your name creating silent PPO activity?

TIP:  Do your homework before signing up for anything.  If you exercise proper due diligence, you can avoid "buyers remorse."

Links

Articles & Quick Questions

 

Discounts. (2016, December 7). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/discounts-30130.html

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)


Behavioral Health Reimbursement Guide

Find-A-Code's specialty specific Reimbursement Guides give you the coding, billing, and documentation support you need to get paid properly and keep it. With input from customers, coders, and auditors, we have combined all these needs into one great resource for professional services. These books include:

  • Specialty-specific CPT and HCPCS code lists and common categories of ICD-10-CM
  • Insider’s secrets to avoiding denials and getting paid
  • A selection of specialty specific Provider Documentation Guides, an exclusive Find-A-Code clinical documentation improvement tool for teaching ICD-10 in 10 minutes
  • Updates on risk adjustment (e.g., HCC) and value-based reimbursement (e.g., MACRA)
  • Evaluation & Management instructions from an auditor's perspective

And more!

Bundle your Reimbursement Guide with Find-A-Code’s specialty specific ICD-10-CM Coding book, which contains the full list of diagnosis codes you need to bill for your specialty.

 

 



Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Email:
free demo
request yours today
pricing
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.